Is a new ACO payment model on the way?

Is a new ACO payment model on the way?

A new global-risk adjusted model may be more appropriate for accountable care organizations (ACOs), experts argued in a Health Affairs blog post. According to the authors, David Krueger, executive director and medical director of Bellin-Thedacare Healthcare Partners in Northeast Wisconsin, and John Toussaint, CEO of the ThedaCare Center for Healthcare Value: “if an ACO can perform a knee replacement and produce a good outcome, it should be paid a risk- and region-adjusted amount for the outcome delivered. Once risk and region are adjusted, the payment should be nearly the same across the country. Under this model, healthcare systems would simply compete on providing the best outcomes at the greatest efficiency.” However, a new payment system for ACOs won’t work unless there are several other components in place, the authors noted, including the Centers for Medicare & Medicaid Services insuring and reinsuring losses for catastrophic events, reference pricing and a payment mechanism to cover the costs of high-risk patients. Read the full article from FierceHealthFinance